A single centre 10-year experience of Mitrofanoffs procedure for varied indications with its outcome

Background: To evaluate long term efficacy and complications of Mitrofanoffs procedure in patients with bladder dysfunction.Methods: Authors retrospectively reviewed the medical records of 51 patients who underwent construction of a continent catherisable channel (mitrofanoffs and monti) from 2009 till 2019 in our institution. Clinical findings and investigations result along with surgical techniques used were noted for these patients. Postoperative complications along with urinary continence and renal outcome were evaluated.Results: Mean age was 7 years and mean follow up was for 3 years. 27 patients were with neurogenic bladder and 24 with non-neurogenic bladder. The most common type of conduit was appendicovesicostomy (38) followed by illeal monti (12) and ureter (1). The most common stomal site was umbilicus (44) followed by right lower abdominal quadrant (6). Catherterizable conduit complications included stomal leakage in 3, mucosal prolapse at the stoma site in1 and an intra peritoneal leak requiring exploratory laprotomy and revision in1. Relative stomal continence was achieved in 98%. The preoperative serum creatinine & blood urea nitrogen (BUN) at the time of mitrofanoffs procedure at the last follow up after the procedure were sought and compared using Chi square test showed statistically significant improvement (p<0.01). No differences in outcome and complication rates were noted between different types of conduit, sites of implantation, or segments used for augmentation.Conclusions: Mitrofanoff is a safe and reliable procedure in children who are dependent on intermittent catherisation in developing countries. Appendicovesicostomy is our first option followed by yang -monti illeovesicostomy. While stomal continence is excellent patient education, family motivation and cost reduction are important factors for its lasting efficiency.

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Ten years’ experience of augmentation cystoplasty for varied indications and its outcome

International Surgery Journal ◽

10.18203/2349-2902.isj20200999 ◽

2020 ◽

Vol 7 (4) ◽

pp. 1031

Author(s):

Hemangi R. Athawale ◽

Shivaji B. Mane ◽

Natasha Vagheriya ◽

Prathamesh More ◽

Taha Daginawala

Keyword(s):

Serum Creatinine ◽

Neurogenic Bladder ◽

Surgical Techniques ◽

Bladder Augmentation ◽

Renal Outcome ◽

Urinary Continence ◽

Ectopic Ureter ◽

Safe Procedure ◽

Augmentation Cystoplasty

Background: The aim of the study was to evaluate long term efficacy and complications of augmentation cystoplasty in patients with bladder dysfunction. Methods: Our series comprises of 30 patients undergoing enterocystoplasty from March 2009 till December 2019. Clinical findings and investigations result along with surgical techniques used were noted for these patients. Postoperative complications along with urinary continence and renal outcome were evaluated.Results: Mean age of patients was 7 years and their mean follow up was for 4 years. Major complications occurred in 5 patients which were successfully managed and minor complication in 8 patients. Of these 16 patients were with neurogenic bladder and 14 with non-neurogenic bladder. The primary etiology of non-neurogenic bladder was extrophy epispadias complex (10 patients), posterior uretheral valves (2 patients), anterior uretheral valve (1 patient), and bilateral ectopic ureter (1 patient). The primary etiology of neurogenic bladder was meningomyocele (4 patients), anorectal malformation with vertebral anomalies (7 patients), partial sacral ageneis (4), nonneurogenic neurogenic bladder (1 patient). Relative continence was achieved in 97%. The preoperative serum creatinine and blood urea nitrogen (BUN) at the time of bladder augmentation (termed creatinine-1 and BUN-1)and the serum creatinine and BUN at the last follow up after bladder augmentation (termed creatinine-2 and BUN-2)were sought and compared using chi square test showed statistically significant improvement (p<0.01).Conclusions: Augmentation cystoplasty is a necessary and safe procedure to increase the functional capacity of small contracted and poorly compliant bladder and allows patients to achieve relative continence and preserves renal function.

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PROGNOSTIC FACTORS OF RENAL TUMOR RECURRENCE AFTER RADICAL NEPHRECTOMY

British Journal of Surgery ◽

10.1093/bjs/znab160.044 ◽

2021 ◽

Vol 108 (Supplement_3) ◽

Author(s):

G Martínez Izquierdo ◽

A R Arnaiz Pérez ◽

E Escolano Fernández ◽

M Merayo Álvarez ◽

B Carrasco Aguilera ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Radical Nephrectomy ◽

Univariate Analysis ◽

Malignant Neoplasms ◽

Histopathological Analysis ◽

Chi Square ◽

Renal Sinus ◽

Chi Square Test

Abstract INTRODUCTION Renal cell carcinoma (RCC) represents 3% of overall malignant neoplasms in adults. However, its aetiology has not been clearly established. Although surgery represents the cornerstone in treatment, recurrence postoperative rates are around 20-30%, what implies prognostic factors search must be mandatory in order to help to plan de follow-up and the different adjuvant therapy possibilities available in case they were necessary. MATERIAL AND METHODS A retrospective observational study was carried out in 110 patients who underwent radical nephrectomy between 2004 and 2018, with the aim of identifying possible prognostic factors of recurrence of RCC after these surgeries. Preoperative data (epidemiological, comorbidities and laboratory tests), surgical, pathological and variables related to follow-up were taken into account. A univariate and multivariate analysis were performed, using chi-square test and logistic regression, respectively. RESULTS The median follow-up time was 53.5 months (SD = 35.8), time in which 19 patients had a recurrence of RCC after radical nephrectomy (17.2%). Histopathological items such as the surgical piece size, the nodal and microvascular invasion, the renal sinus invasion and the presence of necrosis in the surgical piece were associated with RCC recurrence in the univariate analysis, while only the presence of necrosis in the surgical piece showed a significant result in the multivariate analysis (p = 0.004). CONCLUSIONS Histopathological analysis, highlighting the presence of necrosis in the histological sample, was proved to be the main risk factor of RCC recurrence.

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Remeex® System Effectiveness in Male Patients with Stress Urinary Incontinence

Journal of Clinical Medicine ◽

10.3390/jcm10102121 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2121

Author(s):

Gerardo-Alfonso Márquez-Sánchez ◽

Bárbara-Yolanda Padilla-Fernández ◽

Miguel Perán-Teruel ◽

Pedro Navalón-Verdejo ◽

Sebastián Valverde-Martínez ◽

...

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Surgical Techniques ◽

High Survival ◽

Complication Rates ◽

Exact Test ◽

Number Of Patients ◽

Male Stress Urinary Incontinence ◽

Group B

Background: When conservative management fails, patients with stress urinary incontinence (SUI) are considered for surgical treatment. Simpler, more economical and less invasive surgical techniques, such as the Remeex® system, have been developed. Objectives: To analyze the objective effectiveness of the Remeex® system in the treatment of male stress urinary incontinence. To study survival and complication rates of the Remeex® system in male SUI patients. Materials and methods: Prospective observational study between July 2015 and May 2020. Group A (n = 7; GA) patients with mild SUI. Group B (n = 22; GB) patients with moderate SUI. Group C (n = 18; GC) patients with severe SUI. Effectiveness was assessed by the number of patients achieving complete and partial dryness. Complete dryness was defined as patients using 0–1 safety pads per day; partial dryness as a >50% reduction in the number of pads used. Results were analyzed using descriptive statistics, Student’s t-test. Chi2, Fisher’s exact test, ANOVA, and multivariate analysis. Significance was set at p < 0.05. Results: Mean age 69.76 years, mean follow-up 33.52 months. Objective effectiveness was observed in 89.36% of patients with incontinence. The effectiveness was 85.71% in GA, 90.91% in GB and 88.89% in GC. There were no significant differences among groups (p = 1.0000). 34.04% of patients with an implant required at least one readjustment, while 66.00% did not require any. There were no significant differences among groups (p = 0.113) Chi2 = 4.352. 95.74% of implants remained in place by the end of follow-up. We observed complications in 17.02% of patients. Conclusions: Remeex® system is an effective and safe method for male stress urinary incontinence treatment, regardless of the severity of the incontinence, with high survival and low complication and removal rates. System readjustments are required in one-third of the cases.

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Association of cervical carcinogenesis risk with HPV16 E6 and E7 variants in the Taizhou area, China

BMC Cancer ◽

10.1186/s12885-021-08531-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mei-Zhen Dai ◽

Yi Qiu ◽

Xing-Hong Di ◽

Wei-Wu Shi ◽

Hui-Hui Xu

Keyword(s):

Cervical Cancer ◽

Cervical Carcinogenesis ◽

Chi Square ◽

Major Health Problem ◽

Hpv16 E6 ◽

Exact Test ◽

Chi Square Test ◽

E6 And E7

Abstract Background Human papillomavirus (HPV) type 16 accounts for a larger share of cervical cancer and has been a major health problem worldwide for decades. The progression of initial infection to cervical cancer has been linked to viral sequence properties; however, the role of HPV16 variants in the risk of cervical carcinogenesis, especially with longitudinal follow-up, is not fully understood in China. Methods We aimed to investigate the genetic variability of HPV16 E6 and E7 oncogenes in isolates from cervical exfoliated cells. Between December 2012 and December 2014, a total of 310 single HPV16-positive samples were selected from women living in the Taizhou area, China. Sequences of all E6 and E7 oncogenes were analysed by PCR-sequencing assay. Detailed sequence comparison, genetic heterogeneity analyses and maximum-likelihood phylogenetic tree construction were performed with BioEdit Sequence Alignment Editor and MEGA X software. Data for cytology tests and histological diagnoses were obtained from our Taizhou Area Study with longitudinal follow-up for at least 5 years. The relationship between HPV16 variants and cervical carcinogenesis risk was analysed by the chi-square test or Fisher’s exact test. Results In this study, we obtained 64 distinct variation patterns with the accession GenBank numbers MT681266-MT681329. Phylogenetic analysis revealed that 98.3% of HPV16 variants belong to lineage A, in which the A4 (Asian) sublineage was dominant (64.8%), followed by A2 (12.1%), A1 (11.4%), and A3 (10.0%). The A4 (Asian) sublineage had a higher risk of CIN2+ than the A1–3 (European) sublineages (OR = 2.69, 95% CI = 1.04–6.97, P < 0.05). Furthermore, nucleotide variation in HPV16 E6 T178G is associated with the development of cervical cancer. Conclusion These data could provide novel insights into the role of HPV16 variants in cervical carcinogenesis risk in China.

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A comparison of screw versus drill and curettage epiphysiodesis to correct leg-length discrepancy

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.12.180030 ◽

2018 ◽

Vol 12 (5) ◽

pp. 509-514 ◽

Cited By ~ 1

Author(s):

M. Troy ◽

B. Shore ◽

P. Miller ◽

S. Mahan ◽

D. Hedequist ◽

...

Keyword(s):

Operative Time ◽

Surgical Techniques ◽

Leg Length Discrepancy ◽

Complication Rates ◽

Leg Length ◽

Treatment Groups ◽

Length Discrepancy ◽

Baseline Activity ◽

Significant Difference

Purpose To compare two common surgical techniques of epiphysiodesis: drill/curettage epiphysiodesis (PDED) versus cross screw epiphysiodesis (PETS). The hypothesis is that the two techniques have similar efficacy but demonstrate differences in length of hospital stay (LOS), time to return to activity and complication rates. Methods A retrospective review of growing children and adolescents less than 18 years old who required an epiphysiodesis with leg-length discrepancy (LLD) of 2 cm to 6 cm with minimum two years of follow-up was conducted. Characteristics including age at surgery, gender, epiphysiodesis location, side, operative time, LOS and hardware removal were compared across treatment groups. LLD, expected growth remaining (EGR) and bone age were determined preoperatively and at most-recent visit. The correction ratio (change in EGR) was calculated along with a 95% confidence interval (CI) to assess if correction in leg length was achieved. Results A total of 115 patients underwent epiphysiodesis in the femur (53%), tibia (24%) or a combination (24%). The cohort was 47% male, with a mean age of 12.6 years (7.7 to 17.7) at surgery. Median follow-up was 3.7 years (2.0 to 12.7). In all, 23 patients underwent PETS and 92 patients had PDED. Both treatment groups achieved expected LLD correction. There was no significant difference in median operative time, complication rates or LOS. PETS patients returned to activity at a mean 1.4 months (interquartile range (IQR) 0.7 to 2.1) while PDED patients returned at a mean 2.4 months (IQR 1.7 to 3) (p < 0.001). Conclusion Effectiveness in achieving expected correction, LOS and operative time are similar between screw and drill/curettage epiphysiodesis. Patients undergoing PETS demonstrated a faster return to baseline activity than patients with PDED. Level of Evidence: III

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Evaluation of laboratory markers of progression of HIV disease to death

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822011005000062 ◽

2011 ◽

Vol 44 (6) ◽

pp. 657-660 ◽

Cited By ~ 1

Author(s):

Graça Maria de Castro Viana ◽

Maria do Desterro Soares Brandão Nascimento ◽

Aila de Menezes Ferreira ◽

Érica Milena Fernandes Rabelo ◽

João Arnaud Diniz Neto ◽

...

Keyword(s):

Viral Load ◽

Hiv Disease ◽

Significant Relation ◽

Chi Square ◽

Laboratory Markers ◽

Cd4 Lymphocyte Count ◽

Chi Square Test ◽

Cd4 Lymphocyte ◽

Hiv Aids

INTRODUCTION: One of the important current problems in HIV/AIDS infection is the establishment of epidemiological and laboratorial prognostic parameters during patient follow-up. This study aimed at analyzing the evolution of laboratory tests: CD4 lymphocyte count, viral load, hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the epidemiological variables sex and age as prognostic factors for survival in progression to death among AIDS patients. METHODS: A retrospective study was conducted using analysis of medical records, and prospective 24-month follow-up of patients with HIV/ AIDS attended at the President Vargas Hospital Outpatient Clinic, a reference center in HIV/ AIDS attendance in the State of Maranhão, Brazil. The study analyzed patients aged 10 to 60 years old, who manifested AIDS and who were not using antiretroviral therapy or had used it for less than 5 years. The Chi-square test was used for statistical analysis. RESULTS: The sample included 100 patients - 57 were current outpatients, and 43 had died. The variables viral load (p=0.726), ALT (p=0.314), sex (p=0.687), and age (p=0.742) were analyzed, and no evidence of association between them and worst prognosis was observed. CONCLUSIONS: A significant relation was verified between low Hb levels (p=0.000) and CD4 (p=0.000) and shorter survival.

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Risk Factors for Dysphagia After Anterior Cervical Discectomy and Fusion With the Zero-P Implant System: a Retrospective Study With Minimum of 2 Years Follow-up

10.21203/rs.3.rs-138933/v1 ◽

2021 ◽

Author(s):

Rong Xue ◽

Ningdao Li ◽

Zhurong Ji ◽

Xingdong Cheng ◽

Zhuqiu Zhang ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Operation Time ◽

Anterior Cervical Discectomy ◽

Postoperative Dysphagia ◽

Chi Square ◽

Chi Square Test ◽

Implant System ◽

Segmental Angle

Abstract Background: Dysphagia is one of the most common complications after anterior cervical spine surgery. The study aimed to evaluate the risk factors for dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System by multidimensional analysis and investigated the predictive values of these risk factors for dysphagia. Methods: A retrospective analysis of 260 patients who underwent ACDF with the Zero-P Implant System and had at least 2 year of follow-up ware performed. All patients were divided into a non-dysphagia group and a dysphagia group. Sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue thickness, the levels of surgery, O-C2 angle, C2–7 angle, T1 slope and segmental angle were analyzed. Chi-square test and logistic regression were performed to analyze the predictive value of each dimension for dysphagia. Results: In total, the non-dysphagia group comprised 170 patients and the dysphagia group comprised 90 patients. Chi-square test results indicated that number of operated levels, operation time dT1 slope, dO-C2 angle, dC2–7 angle, segmental angle and dPSTT were associated with a high incidence of dysphagia. Multivariate logistic regression analysis showed that number of operated levels, operation time, dC2–7 angle and dPSTT were significantly associated with postoperative dysphagia.Conclusions: Number of operated levels, operation time, dC2–7 angle and dPSTT were significantly associated with postoperative dysphagia. In additionally, sufficient preoperative preparation, evaluation combining with proficient and precise treatment measures are suggested to reduce the incidence of postoperative dysphagia when ACDF is performed.

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More focus on atypical glandular cells in cervical screening: Risk of significant abnormalities and low histological follow-up rate

CytoJournal ◽

10.25259/cytojournal_77_2019 ◽

2020 ◽

Vol 17 ◽

pp. 22

Author(s):

Pingping Zhong ◽

Chenghong Yin ◽

Yulan Jin ◽

Tianbao Chen ◽

Yang Zhan ◽

...

Keyword(s):

Statistical Significance ◽

Cervical Screening ◽

Close Relation ◽

Prior History ◽

Pap Smears ◽

Chi Square ◽

Glandular Cells ◽

Atypical Glandular Cells ◽

Chi Square Test

Objectives: Atypical glandular cells (AGC) detected by Papanicolaou (Pap) smears are in close relation with adenocarcinoma and precursors detected by histopathology. Yet, sometimes the cytological diagnosis of AGC has been neglected. With increase of adenocarcinoma and precursors, we need more focus on glandular abnormalities. Material and Methods: Clinicopathological data of patients who had AGC on Pap smears between April 2015 and October 2018 and underwent histological follow-up were retrieved from the computerized database of Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Patients with a prior history of cancer were excluded from the study. Statistical analyses were performed using Pearson’s Chi-square test in SPSS software version 23. P < 0.05 (two sided) was considered as statistical significance. Results: Liquid-based cytological examination of the uterine cervix was carried out in 164,080 women. Five hundred and twenty-five women were diagnosed with AGC, 314 with not otherwise specified (AGC-NOS), and 211 with favor neoplastic (AGC-FN). Only 310 cases had histological follow-up, 168 women (168/314, 53.5%) originally with AGC-NOS on Pap smears, and 142 (142/211, 67.3%) with AGC-FN. The median age of histological significant abnormalities was 46.7 years, and 126 women (126/162, 77.8%) were postmenopausal. Sixty-six cases (66/168, 39.3%) of AGC-NOS had significant abnormalities (96/142, 67.6%, AGC-FN). One hundred and sixty-two cases of significant abnormalities included 40 high-grade squamous abnormalities and 122 glandular abnormalities. AGC-FN was more likely to be associated with a clinically significant abnormalities (P < 0.001) compared to AGC-NOS. Conclusions: Patients with AGC on Pap smears are in close relation with significant abnormalities, especially with significant glandular abnormalities on histopathology slices. AGC should be evaluated vigilantly with histological workup, especially if patients are diagnosed with AGC-FN and are aged 41–60 years. We need more focus on AGC.

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Evaluation of crestal bone resorption around cylindrical and conical implants following 6 months of loading: A randomized clinical trial

European Journal of Dentistry ◽

10.4103/ejd.ejd_38_17 ◽

2017 ◽

Vol 11 (03) ◽

pp. 317-322 ◽

Cited By ~ 1

Author(s):

Naser Sargolzaie ◽

Hamid Reza Arab ◽

Marzieh Mohammadi Moghaddam

Keyword(s):

Bone Loss ◽

Chi Square ◽

Pocket Depth ◽

Significance Level ◽

Crestal Bone Loss ◽

Significant Difference ◽

Chi Square Test ◽

Male Patients ◽

Maxilla And Mandible

ABSTRACT Objective: The purpose of this clinical study was to evaluate the effect of implant body form (cylindrical and conical implants) on crestal bone levels during 6 months' follow-up after loading. Materials and Methods: A total of 32 SPI implants (19 conical implants/13 cylindrical implants) were randomly placed in 12 male patients using a submerged approach. None of the patients had compromising medical conditions or parafunctional habits. Periapical radiographs using the parallel technique were taken after clinical loading and 6 months later. Clinical indices including pocket depth and bleeding on probing (BOP) were recorded on 6-month follow-up. Data were analyzed by independent samples t-test and Chi-square test with a significance level of 0.05. Results: Six months after loading, crestal bone loss was 0.84 (±0.29) mm around the cylindrical implants and 0.73 (±0.62) mm around the conical types, which was not significantly different (P = 0.54). Pocket depth around the cylindrical and conical implants was 2.61 (±0.45) mm and 2.36 (±0.44) mm, respectively (P = 0.13). BOP was observed among 53.8% and 47.4% of the cylindrical implants and conical (P = 0.13). Bone loss and pocket depth in the maxilla and mandible had no significant difference (P = 0.46 and P = 0.09, respectively). Conclusion: In this study, although bone loss and clinical parameters were slightly higher in the cylindrical implants, there was no significant difference between the conical- and cylindrical-shaped implants.

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Functional outcome and complications following surgery for Dupuytren’s disease: a multi-centre cross-sectional study

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193416660045 ◽

2016 ◽

Vol 42 (1) ◽

pp. 7-17 ◽

Cited By ~ 9

Author(s):

J. N. Rodrigues ◽

W. Zhang ◽

B. E. Scammell ◽

I. Chakrabarti ◽

P. G. Russell ◽

...

Keyword(s):

Monte Carlo Simulation ◽

Monte Carlo ◽

Functional Outcome ◽

Dupuytren’S Disease ◽

Complication Rates ◽

Loss Of Function ◽

Chi Square ◽

Level Of Evidence ◽

Dupuytren's Disease ◽

Chi Square Test

Variables associated with recurrent Dupuytren’s disease, or a ‘diathesis’, have been investigated, but those associated with functional outcome and complications are less well studied. Outcomes 1 or 5 years after an aponeurotomy, fasciectomy or dermofasciectomy were assessed by patient interview and examination at five UK centres. A total of 432 procedures were studied. The reoperation rate did not differ at 1 year ( p = 0.396, Chi-square test with Monte Carlo simulation), but was higher after aponeurotomy in the 5-year group (30%, versus 6% after fasciectomy and 0% after dermofasciectomy, p = 0.003, Chi square test with Monte Carlo simulation). Loss of function (DASH>15) did not differ between procedures at 5 years, even when reoperation and other variables were controlled. Diabetes, female gender and previous ipsilateral surgery were associated with poorer function in logistic regression analysis. The variables associated with poor function after treatments differ from diathesis variables. Aponeurotomy had lower complication rates than fasciectomy and dermofasciectomy. This may counterbalance the former’s higher recurrence rate and explain why aponeurotomy demonstrated similar long-term functional outcome compared with excisional surgery in this study. Level of evidence: III

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